If we all had guts that did  what guts are supposed to do, we wouldn’t be making this video.

Unfortunately, several of  the people who make SciShow are all too aware that their guts  could be doing a much better job. And since you’re watching this video, you might also be a member  of the Slacking Gut Club.

Membership comes with inflammatory bowel disease, or if you’re a top tier  member, C. diff infections! But it might not be your gut’s fault. This stuff often comes down to the tiny organisms that call your gut home: your gut microbiota.

Some people just have worse  gut microbiota than others. And if you’re one of those folks, here’s what researchers know  about how to get a better one. [♪ INTRO] Welcome to the Slacking Gut Club orientation. There are a lot of new names and  …faces? …flagella? to get to know.

A healthy gut microbiota has up to  2,000 different species of bacteria, viruses, archaea, and fungi in it. And the microbiome is the collective  genes and products of all those guys. Your gut microbiome helps maintain all  sorts of important stuff in your body, like your metabolism, mucus  barriers, and immune responses.

So if you’re lucky, you have  thousands of different kinds of microorganisms inside your gut right  now keeping everything running smoothly. And luck is definitely a factor. You’re not totally in control  of who resides in your gut.

You get some of your microbiota  from birth, some from your diet, and some from hospitalizations or  conditions you pick up throughout the years. Plus a ton of other factors that come with living. So everybody’s gut microbiome is different.

But if you have one that puts you  solidly in the Slacking Gut Club, you’d probably like to turn it into a better one. And there are experts trying to help  make that happen for you... and me. The idea that’s gained the most traction is known as microbiota replacement therapy.

If you have medical concerns related  to your sub-par gut microbiota, you can sample someone else’s healthier gut microbiota and take on its good qualities. Technically you can do this in a few ways. But some are more effective than others.

Like, you can try to seed a good gut  microbiota with over-the-counter probiotics. This is a pretty easy and accessible option. But the downside is: data’s  not really on your side.

So far, probiotics have not consistently been found to help much with your gut microbiome. One problem is that we don’t know yet how to grow some gut microbes outside your body. And if we can’t grow them, we  can’t put them into a probiotic.

Also, there are only so  many microbes in probiotics. And generally, healthy guts  have a ton of microbial diversity in them that you won’t  get from that limited boost. Which means probiotics might not be  the quick fix you were hoping for.

Instead, you might find success  with a fecal microbiota transplant. That’s when you get a person to donate their poop, complete with gut microbiota galore. Then, the professionals water  down your donor poop and filter that mixture into a  syringe to shoot it up your butt.

Not once. Not twice. But lots of times for weeks.

What’s a little sharing poop between  friends with the help of some doctors? Am I right? And, I promise it’s not  joke, it really is healing.

Depending on what problem you’re  trying to solve with the transplant, the treatment can work wonders. For example, a 2015 paper reported that patients with active ulcerative colitis  received fecal microbiota transplants and achieved remission in a matter of weeks. Those folks had significantly  less inflammation down there, and some even had no inflammation  by the end of the study.

Now, the effects might not last forever. But they still can help you live a  healthier, happier life for years. And when the effect starts wearing off, you can get another transplant  to prolong the benefits.

Just think about it like pen pals, but poop pals. So I’m a science communicator and  I’m used to talking about poop, and it can be off-putting to think  about someone else’s poop inside of you. But you have to give it to  those scientific results!

And there may be more palatable  transplant options coming out. Researchers are working on modifying  this therapy into capsules, so you can swallow a pill instead of going through the whole “syringe full of poop water” ordeal. The thing is, though, the ick factor isn’t the only thing keeping us all from perfect poops.

Unfortunately, not all fecal  transplants are equally curative. In that 2015 study, only 9 of the 38 patients who got a fecal microbiota  transplant entered remission. And the researchers have some ideas about why.

For one thing, timing might be a factor. Three of the four patients  who had just started reporting symptoms of ulcerative colitis  entered remission after treatment. And three quarters is a much higher success  rate than the six out of 34 patients who achieved remission after  longer term ulcerative colitis.

So if you get a fecal microbiota  transplant in your first year of symptoms, you might have better chances of remission. But that’s not the only factor here. There’s also microbial diversity to consider.

Research suggests that the benefit you  get from a fecal microbiota transplant may be dependent on getting a good  donor with a really diverse microbiome. Back to that 2015 study, of the nine  patients who achieved remission, seven used the same donor. I guess you could call this guy a super pooper!

I mean, the scientists didn’t, but we could. The researchers actually  used the term super-donor, and these folks have particularly  diverse gut microbiomes. And it’s not like the rest  of us, non super-doners, are walking around with only a few  kinds of microscopic gut roommates.

One study found that stool donors  who don’t produce responses in their recipients still have  almost 800 species to brag about! It’s just that the donors who get remission  results have more like 950 species. And that extra diversity in donor microbes  really seems to make a difference.

Now, if you’re trying to increase the microbial  diversity in your gut for best results, you might consider combining  multiple poops from different donors. But when it comes to remission, a rag tag team of average poopers  doesn’t compare to a single super donor. Some experts are taking this super  donor idea and running with it.

But before we get to what they’re  doing with that super poop, it’s time for a quick ad. Thanks to Zocdoc for  sponsoring this SciShow video! Zocdoc is a free website where you  can search and compare high quality, in-network doctors and click to  instantly book an appointment.

With over 150,000 providers across more  than 200 specialties in all 50 US states, you can book an appointment within 24 to 72 hours. When the SciShow script writer  on staff has medical needs, she goes to Zocdoc first. She’s used them to find a new  doctor when she moved to a new city.

Then again when her amazing  doctor she found on Zocdoc switched practices and she  needed to start over again. And she used them for her husband too when he had a medical need crop up suddenly. With Zocdoc, she’s been able  to find professionals that specialize in the stuff she needs.

And make sure they’re in  network with her insurance. And book an appointment in a few minutes  for a date that’s not a year out. You don’t have to sit on the phone  listening to the worst hold music you’ve ever heard or have a 20  minute long conversation with a bot.

Zocdoc lets you handle everything yourself  on their free, straightforward website. With a really short time commitment on  Zocdoc, you can get the ball rolling today. Taking care of your health just got easier.

Head to zocdoc.com/SCISHOW to get started and check that appointment off your to-do list. Thanks again to Zocdoc for  sponsoring today’s video! The way fecal donations work today, donors already need to be pre-screened  to make sure they don’t have any nasty bugs in them that  would cause more harm than good.

So that step could be expanded to screen for the presence of the most beneficial microbes. In a perfect world, we could identify  super donors and use the best poop for all fecal microbiota transplants. We just need to know which species are good to have around and  which should be avoided.

Researchers have identified  a couple of kinds of bacteria that generally show up when  patients don’t achieve remission. Some of the microbes you’d want to keep around are classified as Clostridium cluster IV bacteria. These bacteria, associated with prolonged  clinical remission from inflammatory bowel disease, are known for their  work supporting your immune system.

So they’re top notch microbes. But there are a lot of them  in that giant category. And if you were searching for one keystone  gut species that you really want in your donor stool, that species would depend  on what problem you’re trying to solve.

For example, if you’re getting a fecal  microbiota transplant because of your IBS, maybe you’d want to place  your bets on Bifidobacterium. It can be tempting to work toward  highly personalized therapies that focus on specific microbes. But not all experts are on board  with that idea because some say species richness is more important than  any specific species being transferred.

If we do make our way toward more  personalized fecal microbiota transplants, maybe it would look less like worrying  about which species are transplanted and more like ensuring that the  donors and recipients are compatible. Your gut microbiota influences your immune system. And your immune system  influences your gut microbiota.

And if your immune system  mounts a supercharged response to the transplanted microbes, you may  just be incompatible with that donor. Luckily, there are other ways  to modify your gut microbiota that don’t involve transplants. You can totally change your gut microbiota within 24 hours by changing what you eat.

In a study published in the journal “Nature,” volunteers began eating either  entirely animal based foods, with the exception of coffee,  or entirely plant based foods. None of them had been following  those diets beforehand and they all measurably changed  what they ate during the study. People in the animal group added fat and  protein to their overall food intake.

And people in the plant group added fiber. After just five days, their  gut microbes started resembling what you’d see in carnivores and herbivores. Not just by increasing or decreasing the  proportions of microbes they already had, but also by introducing totally new ones.

The animal based diet had a bigger effect on how many kinds of microbes  increased or decreased in abundance. But a lot of change isn’t necessarily good. For example, there’s one genus that happens to be associated with remission of Crohn’s disease.

And for at least one of the animal  eaters, the genus decreased. So an animal based diet might be  lacking some positive gut microbes. And what’s worse, it might  promote some negative ones.

People who ate the animal based diet had more microbes associated with  inflammatory bowel disease. So please talk to your doctor  before making any drastic changes. But this data suggests you might lean on plants to help create a nice environment in your gut.

And an important caveat is that  the changes to your gut microbiota go away almost as fast as they arrive. So you do have to keep up these  diets to maintain the effects. And if changing your diet is  impractical or impossible for you, there’s still another trick you can try.

Exercise has also been shown to  quickly change your gut microbiota. In studies, excercise has changed the  composition of gut microbiota in rodents and increased its diversity  in professional athletes. But I’m assuming that you, like me, are  not a rodent or a professional athlete.

So here’s some research on amateur runners that might be more relevant to  your life, my life, you know: The study, published in the journal  “Frontiers in Microbiology,” found that running just one half marathon changed the composition of gut microbiota  in the people who participated. That’s based on samples taken  before and after the race. So literally one day made a difference.

As for which microbes changed, one example  is an increase in a type of bacteria that helps your cells perform  their basic functions, like signaling, storing energy,  and maintaining their membranes. As if you needed another reason to exercise. But in that study, they didn’t separate  the effects of diet and exercise.

So that half marathon alone didn’t  necessarily cause all of those changes. Remember, your gut microbiome is unique  to you just like mine is unique to me. So you might have to go through a period of bouncing ideas around with your  doctor and trying things out.

Whether it’s a new diet, new exercise,  or finding a compatible super donor for your next fecal microbiota transplant, there are a lot of ways to take care of your gut. As the super donor researchers say, it’s  not a “one stool to rule them all” approach. [♪ OUTRO]